Lymphomas After Solid Organ Transplantation: A Collaborative Transplant Study Report
By G. Opelz, B. Döhler. American Journal of Transplantation, 2004
1,117 citations recorded by the source corpus.
We used the Collaborative Transplant Study database to analyze the incidence, risk, and impact of malignant lymphomas in approximately 200 000 organ transplant recipients. Over a 10‐year period, the risk in renal transplant recipients was 11.8‐fold higher than that in a matched nontransplanted population (p < 0.0001). The majority of lymphomas were diagnosed after the first post‐transplant year. Heart‐lung transplants showed the highest relative risk (RR 239.5) among different types of organ transplants. In kidney recipients, immunosuppression with cyclosporine did not confer added risk compared with azathioprine/steroid treatment, whereas treatment with FK506 increased the risk approximately twofold. Induction therapy with OKT3 or ATG, but not with anti‐IL2 receptor antibodies, increased the risk of lymphoma during the first year. Antirejection therapy with OKT3 or ATG also increased the risk. First‐year mortality in renal and heart transplant patients with lymphoma was approximately 40% and 50%, respectively, and showed no improvement in recent years. A pattern of preferential localization to the vicinity of the transplant was noted, and the prognosis of the patient was related to localization. This study highlights the continuing risk for lymphoma with time post‐transplantation, the contribution of immunosuppression to increased risk, and continuing poor outcomes in patients with post‐transplant lymphoma.
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Citations in the corpus
- Infection in Organ Transplantation (2017, background): “Late PTLD includes more monomorphic B cell tumors, EBV-negative proliferations (up to 20%), or NK cell or T cell tumors (99,100).”
- Cancer after Kidney Transplantation in the United States (2004, background): “However, we did not examine the effects of these agents on individual tumors, and others have reported that antibody induction was associated with posttransplant lymphomas (14,15).”
- The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients. (2010, result): “In contrast, data from a registry that included 25,000 transplant patients failed to reveal such association.(165) Moreover, ATG may have a protective effect against PTLD if antiviral prophylaxis is used after induction therapy.”